Skip to main content

Simulation for Pediatric Emergency Medicine and Trauma

  • Chapter
  • First Online:
  • 2005 Accesses

Part of the book series: Comprehensive Healthcare Simulation ((CHS))

Abstract

Pediatric emergency medicine (PEM) is a broad and complex subspecialty that manages a wide spectrum of patients including critically ill and injured children requiring highly skilled clinicians working effectively as a team. Simulation is currently used in a variety of formats to accomplish teaching objectives in training programs and standardized courses. It is also used for systems testing and quality improvement programs in pediatric emergency departments to assist in providing high-quality and safe patient care. There are common challenges associated with integrating and sustaining PEM simulation programs, but the current benefits and future potential related to PEM simulation are promising.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Allan CK, Thiagarajan RR, Beke D, Imprescia A, Kappus LJ, Garden A, et al. Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams. J Thorac Cardiovasc Surg. 2010;140(3):646–52.

    Article  PubMed  Google Scholar 

  2. Tan SB, Pena G, Altree M, Maddern GJ. Multidisciplinary team simulation for the operating theatre: a review of the literature. ANZ J Surg. 2014;84(7–8):515–22.

    Article  PubMed  Google Scholar 

  3. Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med. 2011;12(1):33–8.

    Article  PubMed  Google Scholar 

  4. Morey JC, Simon R, Jay GD, Wears RL, Salisbury M, Dukes KA, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res. 2002;37(6):1553–81.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Shapiro MJ, Morey JC, Small SD, Langford V, Kaylor CJ, Jagminas L, et al. Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum? Qual Saf Health Care. 2004;13(6):417–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Adler MD, Vozenilek JA, Trainor JL, Eppich WJ, Wang EE, Beaumont JL, et al. Development and evaluation of a simulation-based pediatric emergency medicine curriculum. Acad Med. 2009;84(7):935–41.

    Article  PubMed  Google Scholar 

  7. Stone K, Reid J, Caglar D, Christensen A, Strelitz B, Zhou L, et al. Increasing pediatric resident simulated resuscitation performance: a standardized simulation-based curriculum. Resuscitation. 2014;85(8):1099–105.

    Article  PubMed  Google Scholar 

  8. Kern DE, Thomas PA, Hughs MT. Curriculum development for medical education: a six-step approach. 2nd ed. Baltimore: Johns Hopkins University Press; 2009.

    Google Scholar 

  9. Reid J, Stone K, Brown J, Caglar D, Kobayashi A, Lewis-Newby M, et al. The simulation team assessment tool (STAT): development, reliability and validation. Resuscitation. 2012;83(7):879–86.

    Article  PubMed  Google Scholar 

  10. Cheng A, Goldman RD, Aish MA, Kissoon N. A simulation-based acute care curriculum for pediatric emergency medicine fellowship training programs. Pediatr Emerg Care. 2010;26(7):475–80.

    Article  PubMed  Google Scholar 

  11. Bank I, Cheng A, McLeod P, Bhanji F. Determining content for a simulation-based curriculum in pediatric emergency medicine: results from a national Delphi process. CJEM. 2015;17(6):662–9. doi: 10.1017/cem.2015.11.

    Google Scholar 

  12. Nishisaki A, Hales R, Biagas K, Cheifetz I, Corriveau C, Garber N, et al. A multi-institutional high-fidelity simulation “boot camp” orientation and training program for first year pediatric critical care fellows. Pediatr Crit Care Med. 2009;10(2):157–62.

    Article  PubMed  Google Scholar 

  13. Wayne DB, Cohen ER, Singer BD, Moazed F, Barsuk JH, Lyons EA, et al. Progress toward improving medical school graduates’ skills via a “boot camp” curriculum. Simul Healthc. 2014;9(1):33–9.

    Article  PubMed  Google Scholar 

  14. Fernandez GL, Page DW, Coe NP, Lee PC, Patterson LA, Skylizard L, et al. Boot cAMP: educational outcomes after 4 successive years of preparatory simulation-based training at onset of internship. J Surg Educ. 2012;69(2):242–8.

    Article  PubMed  Google Scholar 

  15. Steinemann S, Berg B, Skinner A, DiTulio A, Anzelon K, Terada K, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ. 2011;68(6):472–7.

    Article  PubMed  Google Scholar 

  16. Patterson MD, Blike GT, Nadkarni VM. Advances in patient safety in situ simulation: challenges and results. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in patient safety: new directions and alternative approaches (Vol 3: performance and tools). Rockville: Agency for Healthcare Research and Quality (US); 2008.

    Google Scholar 

  17. Kamdar G, Kessler DO, Tilt L, Srivastava G, Khanna K, Chang TP, et al. Qualitative evaluation of just-in-time simulation-based learning: the learners’ perspective. Simul Healthc. 2013;8(1):43–8.

    Article  PubMed  Google Scholar 

  18. Nishisaki A, Donoghue AJ, Colborn S, Watson C, Meyer A, Brown CA 3rd, et al. Effect of just-in-time simulation training on tracheal intubation procedure safety in the pediatric intensive care unit. Anesthesiology. 2010;113(1):214–23.

    Article  PubMed  Google Scholar 

  19. Niles D, Sutton RM, Donoghue A, Kalsi MS, Roberts K, Boyle L, et al. “Rolling Refreshers”: a novel approach to maintain CPR psychomotor skill competence. Resuscitation. 2009;80(8):909–12.

    Article  PubMed  Google Scholar 

  20. Hunt EA, Hohenhaus SM, Luo X, Frush KS. Simulation of pediatric trauma stabilization in 35 North Carolina emergency departments: identification of targets for performance improvement. Pediatrics. 2006;117(3):641–8.

    Article  PubMed  Google Scholar 

  21. TRIK Course. http://www.royalcollege.ca/portal/page/portal/rc/resources/ppi/trik_course.

  22. Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, et al. “Booster” training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of pediatric basic life support providers during simulated cardiac arrest. Pediatr Crit Care Med. 2011;12(3):e116–21.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Sutton RM, Niles D, Meaney PA, Aplenc R, French B, Abella BS, et al. Low-dose, high-frequency CPR training improves skill retention of in-hospital pediatric providers. Pediatrics. 2011;128(1):e145–51.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Nishisaki A, Scrattish L, Boulet J, Kalsi M, Maltese M, Castner T, et al. Advances in patient safety effect of recent refresher training on in situ simulated pediatric tracheal intubation psychomotor skill performance. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in patient safety: new directions and alternative approaches (Vol 3: performance and tools). Rockville: Agency for Healthcare Research and Quality (US); 2008.

    Google Scholar 

  25. Shefrin A, Khazei A, Cheng A. HYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/26451232”Realism of procedural task trainers in a pediatric emergency medicine procedures course. Can Med Educ J. 2015;6(1):e68–73.

  26. Sigalet E, Donnon T, Cheng A, Cooke S, Robinson T, Bissett W, et al. Development of a team performance scale to assess undergraduate health professionals. Acad Med. 2013;88(7):989–96.

    Article  PubMed  Google Scholar 

  27. Sigalet E, Donnon T, Grant V. Undergraduate students’ perceptions of and attitudes toward a simulation-based interprofessional curriculum: the KidSIM ATTITUDES questionnaire. Simul Healthc. 2012;7(6):353–8.

    Article  PubMed  Google Scholar 

  28. Overly FL, Sudikoff SN, Duffy S, Anderson A, Kobayashi L. Three scenarios to teach difficult discussions in pediatric emergency medicine: sudden infant death, child abuse with domestic violence, and medication error. Simul Healthc. 2009;4(2):114–30.

    Article  PubMed  Google Scholar 

  29. Tobler K, Grant E, Marczinski C. Evaluation of the impact of a simulation-enhanced breaking bad news workshop in pediatrics. Simul Healthc. 2014;9(4):213–9.

    Article  PubMed  Google Scholar 

  30. Nadel FM, Lavelle JM, Fein JA, Giardino AP, Decker JM, Durbin DR. Assessing pediatric senior residents’ training in resuscitation: fund of knowledge, technical skills, and perception of confidence. Pediatr Emerg Care. 2000;16(2):73–6.

    Article  CAS  PubMed  Google Scholar 

  31. Hamilton R. Nurses’ knowledge and skill retention following cardiopulmonary resuscitation training: a review of the literature. J Adv Nurs. 2005;51(3):288–97.

    Article  PubMed  Google Scholar 

  32. Schoenfeld PS, Baker MD. Management of cardiopulmonary and trauma resuscitation in the pediatric emergency department. Pediatrics. 1993;91(4):726–9.

    CAS  PubMed  Google Scholar 

  33. Association AH. Pediatric advanced life support. [Internet] 2014.

    Google Scholar 

  34. Donoghue AJ, Durbin DR, Nadel FM, Stryjewski GR, Kost SI, Nadkarni VM. Effect of high-fidelity simulation on Pediatric Advanced Life Support training in pediatric house staff: a randomized trial. Pediatr Emerg Care. 2009;25(3):139–44.

    Article  PubMed  Google Scholar 

  35. Wayne DB, Butter J, Siddall VJ, Fudala MJ, Linquist LA, Feinglass J, et al. Simulation-based training of internal medicine residents in advanced cardiac life support protocols: a randomized trial. Teach Learn Med. 2005;17(3):210–6.

    Article  PubMed  Google Scholar 

  36. Kurosawa H, Ikeyama T, Achuff P, Perkel M, Watson C, Monachino A, et al. A randomized, controlled trial of in situ pediatric advanced life support recertification (“pediatric advanced life support reconstructed”) compared with standard pediatric advanced life support recertification for ICU frontline providers*. Crit Care Med. 2014;42(3):610–8.

    Article  PubMed  Google Scholar 

  37. Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al. Pediatric resident resuscitation skills improve after “rapid cycle deliberate practice” training. Resuscitation. 2014;85(7):945–51.

    Article  PubMed  Google Scholar 

  38. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(Suppl 10):70–81.

    Article  Google Scholar 

  39. Bhanji F, Mancini ME, Sinz E, Rodgers DL, McNeil MA, Hoadley TA, et al. Part 16: education, implementation, and teams: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):920–33.

    Article  Google Scholar 

  40. Cooper S. Developing leaders for advanced life support: evaluation of a training programme. Resuscitation. 2001;49(1):33–8.

    Article  CAS  PubMed  Google Scholar 

  41. Gilfoyle E, Gottesman R, Razack S. Development of a leadership skills workshop in paediatric advanced resuscitation. Med Teach. 2007;29(9):276–83.

    Article  Google Scholar 

  42. DeVita MA, Schaefer J, Lutz J, Wang H, Dongilli T. Improving medical emergency team (MET) performance using a novel curriculum and a computerized human patient simulator. Qual Saf Health Care. 2005;14(5):326–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Wik L, Myklebust H, Auestad BH, Steen PA. Retention of basic life support skills 6 months after training with an automated voice advisory manikin system without instructor involvement. Resuscitation. 2002;52(3):273–9.

    Article  PubMed  Google Scholar 

  44. Grant EC, Marczinski CA, Menon K. Using pediatric advanced life support in pediatric residency training: does the curriculum need resuscitation? Pediatr Crit Care Med. 2007;8(5):433–9.

    Article  PubMed  Google Scholar 

  45. Hunt EA, Vera K, Diener-West M, Haggerty JA, Nelson KL, Shaffner DH, et al. Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents during simulated cardiopulmonary arrests. Resuscitation. 2009;80(7):819–25.

    Article  PubMed  Google Scholar 

  46. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O’Hearn N, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA. 2005;293(3):305–10.

    Article  CAS  PubMed  Google Scholar 

  47. Sutton RM, Wolfe H, Nishisaki A, Leffelman J, Niles D, Meaney PA, et al. Pushing harder, pushing faster, minimizing interruptions … but falling short of 2010 cardiopulmonary resuscitation targets during in-hospital pediatric and adolescent resuscitation. Resuscitation. 2013;84(12):1680–4.

    Article  PubMed  Google Scholar 

  48. Makker R, Gray-Siracusa K, Evers M. Evaluation of advanced cardiac life support in a community teaching hospital by use of actual cardiac arrests. Heart Lung. 1995;24(2):116–20.

    Article  CAS  PubMed  Google Scholar 

  49. Kaye W. Research on ACLS training—which methods improve skill & knowledge retention? Respir Care. 1995;40(5):538–46. (discussion 46–9).

    CAS  PubMed  Google Scholar 

  50. Mancini ME, Soar J, Bhanji F, Billi JE, Dennett J, Finn J, et al. Part 12: education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010;122(16 Suppl 2):S539–81.

    Article  PubMed  Google Scholar 

  51. Yeung J, Meeks R, Edelson D, Gao F, Soar J, Perkins GD. The use of CPR feedback/prompt devices during training and CPR performance: a systematic review. Resuscitation. 2009;80(7):743–51.

    Article  PubMed  Google Scholar 

  52. Dine CJ, Gersh RE, Leary M, Riegel BJ, Bellini LM, Abella BS. Improving cardiopulmonary resuscitation quality and resuscitation training by combining audiovisual feedback and debriefing. Crit Care Med. 2008;36(10):2817–22.

    Article  PubMed  Google Scholar 

  53. Chamberlain DA, Hazinski MF. Education in resuscitation: an ILCOR symposium: Utstein Abbey: stavanger, Norway: june 22–24, 2001. Circulation. 2003;108(20):2575–94.

    Article  PubMed  Google Scholar 

  54. Cheng A, Rodgers DL, van der Jagt E, Eppich W, O’Donnell J. Evolution of the pediatric advanced life support course: enhanced learning with a new debriefing tool and Web-based module for pediatric advanced life support instructors. Pediatr Crit Care Med. 2012;13(5):589–95.

    Article  PubMed  Google Scholar 

  55. Youngblood P, Harter PM, Srivastava S, Moffett S, Heinrichs WL, Dev P. Design, development, and evaluation of an online virtual emergency department for training trauma teams. Simul Healthc. 2008;3(3):146–53.

    Article  PubMed  Google Scholar 

  56. Mikrogianakis A, Osmond MH, Nuth JE, Shephard A, Gaboury I, Jabbour M. Evaluation of a multidisciplinary pediatric mock trauma code educational initiative: a pilot study. J Trauma. 2008;64(3):761–7.

    Article  PubMed  Google Scholar 

  57. Falcone RA Jr, Daugherty M, Schweer L, Patterson M, Brown RL, Garcia VF. Multidisciplinary pediatric trauma team training using high-fidelity trauma simulation. J Pediatr Surg. 2008;43(6):1065–71.

    Article  PubMed  Google Scholar 

  58. Cherry RA, Ali J. Current concepts in simulation-based trauma education. J Trauma. 2008;65(5):1186–93.

    Article  PubMed  Google Scholar 

  59. Hunt EA, Heine M, Hohenhaus SM, Luo X, Frush KS. Simulated pediatric trauma team management: assessment of an educational intervention. Pediatr Emerg Care. 2007;23(11):796–804.

    Article  PubMed  Google Scholar 

  60. Spanos SL, Patterson M. An unexpected diagnosis: simulation reveals unanticipated deficiencies in resident physician dysrhythmia knowledge. Simul Healthc. 2010;5(1):21–3.

    Article  PubMed  Google Scholar 

  61. O’Leary F, McGarvey K, Christoff A, Major J, Lockie F, Chayen G, et al. Identifying incidents of suboptimal care during paediatric emergencies-an observational study utilising in situ and simulation centre scenarios. Resuscitation. 2014;85(3):431–6.

    Article  Google Scholar 

  62. Patterson MD, Geis GL, LeMaster T, Wears RL. Impact of multidisciplinary simulation-based training on patient safety in a paediatric emergency department. BMJ Qual Saf. 2013;22(5):383–93.

    Article  PubMed  Google Scholar 

  63. Kobayashi L, Dunbar-Viveiros JA, Devine J, Jones MS, Overly FL, Gosbee JW, et al. Pilot-phase findings from high-fidelity In Situ medical simulation investigation of emergency department procedural sedation. Simul Healthc. 2012;7(2):81–94.

    Article  PubMed  Google Scholar 

  64. Vozenilek J, Wang E, Kharasch M, Anderson B, Kalaria A. Simulation-based morbidity and mortality conference: new technologies augmenting traditional case-based presentations. Acad Emerg Med. 2006;13(1):48–53.

    Article  PubMed  Google Scholar 

  65. Wiler JL, Griffey RT, Olsen T. Review of modeling approaches for emergency department patient flow and crowding research. Acad Emerg Med. 2011;18(12):1371–9.

    Article  PubMed  Google Scholar 

  66. Eitel DR, Rudkin SE, Malvehy MA, Killeen JP, Pines JM. Improving service quality by understanding emergency department flow: a White Paper and position statement prepared for the American Academy of Emergency Medicine. J Emerg Med. 2010;38(1):70–9.

    Article  PubMed  Google Scholar 

  67. Hoot NR, LeBlanc LJ, Jones I, Levin SR, Zhou C, Gadd CS, et al. Forecasting emergency department crowding: a discrete event simulation. Ann Emerg Med. 2008;52(2):116–25.

    Article  PubMed  Google Scholar 

  68. Hung GR, Whitehouse SR, O’Neill C, Gray AP, Kissoon N. Computer modeling of patient flow in a pediatric emergency department using discrete event simulation. Pediatr Emerg Care. 2007;23(1):5–10.

    Article  PubMed  Google Scholar 

  69. Kobayashi L, Shapiro MJ, Sucov A, Woolard R, Boss RM 3rd, Dunbar J, et al. Portable advanced medical simulation for new emergency department testing and orientation. Acad Emerg Med. 2006;13(6):691–5.

    Article  PubMed  Google Scholar 

  70. Wiinamaki A, Dronzek R. Using simulation in the architectural concept phase of an emergency department design. Proceedings of the 2003 Winter, Simulation Conference 2003; 2003. Vol. 2, pp. 1912.

    Google Scholar 

  71. Geis GL, Pio B, Pendergrass TL, Moyer MR, Patterson MD. Simulation to assess the safety of new healthcare teams and new facilities. Simul Healthc. 2011;6(3):125–33.

    Article  PubMed  Google Scholar 

  72. Chin L, Fleisher G. Planning model of resource utilization in an academic pediatric emergency department. Pediatr Emerg Care. 1998;14(1):4–9.

    Article  CAS  PubMed  Google Scholar 

  73. Draeger MA. An emergency department simulation model used to evaluate alternative nurse staffing and patient population scenarios. Proceedings of the 24th conference on Winter simulation; 1992. pp. 1057–64.

    Google Scholar 

  74. Evans GW, Tesham BG, Unger E. A simulation model for evaluating personnel schedules in a hospital emergency department. Proceedings of the 28th conference on Winter Simulation IEEE Computer Society; 1996.

    Google Scholar 

  75. Centeno MA, et al. Emergency departments II: a simulation-ilp based tool for scheduling ER staff. Proceedings of the 35th conference on Winter simulation: driving innovation Winter Simulation Conference; 2003.

    Google Scholar 

  76. Hung GR, Kissoon N. Impact of an observation unit and an emergency department-admitted patient transfer mandate in decreasing overcrowding in a pediatric emergency department: a discrete event simulation exercise. Pediatr Emerg Care. 2009;25(3):160–3.

    Article  PubMed  Google Scholar 

  77. Blasak RE, Starks DW, Armel WS, Hayduk MC. The use of simulation to evaluate hospital operations between the emergency department and a medical telemetry unit. Proceedings of the 2003 Winter Simulation Conference 2003; 2003. p. 1887.

    Google Scholar 

  78. Ahmed MA, Alkamis TM. Simulation optimization for an emergency department healthcare unit in Kuwait. Eur J Oper Res. 2009;198:936.

    Article  Google Scholar 

  79. Kobayashi L, Shapiro MJ, Gutman DC, Jay G. Multiple encounter simulation for high-acuity multipatient environment training. Acad Emerg Med. 2007;14(12):1141–8.

    Article  PubMed  Google Scholar 

  80. Kanter RK, Moran JR. Pediatric hospital and intensive care unit capacity in regional disasters: expanding capacity by altering standards of care. Pediatrics. 2007;119(1):94–100.

    Article  PubMed  Google Scholar 

  81. Kaji AH, Bair A, Okuda Y, Kobayashi L, Khare R, Vozenilek J. Defining systems expertise: effective simulation at the organizational level–implications for patient safety, disaster surge capacity, and facilitating the systems interface. Acad Emerg Med. 2008;15(11):1098–103.

    Article  PubMed  Google Scholar 

  82. Patrick J, Puterman ML. Reducing wait times through operations research: optimizing the use of surge capacity. Healthc Policy (Politiques de sante). 2008;3(3):75–88.

    Article  Google Scholar 

  83. McCarthy ML, Aronsky D, Kelen GD. The measurement of daily surge and its relevance to disaster preparedness. Acad Emerg Med. 2006;13(11):1138–41.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frank L. Overly MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Overly, F., Ching, K., Meckler, G. (2016). Simulation for Pediatric Emergency Medicine and Trauma. In: Grant, V., Cheng, A. (eds) Comprehensive Healthcare Simulation: Pediatrics. Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-319-24187-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24187-6_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24185-2

  • Online ISBN: 978-3-319-24187-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics